Facts
- Status
- A
- Credential
- MD
- Type
- Individual
- Enumeration date
- 2013-06-28
- Last updated
- 2024-09-19
Specialties
Licenses
- License RI
- MD15441
Location
- Practice location
- 455 TOLL GATE RD
- City
- WARWICK RI
- Postal code
- 028862759
- Phone
- 401-737-7010
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.